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enormous sputum clearance all the time
I’m finally seeing an ID doc end of this month. I have slight bronchiectasis and MAC. I have endless white/clear sputum. it gurgles in my chest and easily comes past my esophagus all the time. I barely need to start my autogenic drainage, it’s just always ready to be expelled. I do saline nebulizing after a quick albuterol dose every day just in the hopes that the saline is killing some bacteria. This has been my story since November diagnosis. I am 65 and very athletic, my oxygen saturation is excellent. I have two lines of thought. I wonder if you can help me work through. 1) I am leaning towards diving into the big three protocol with fingers crossed, and a hopeful attitude that I will be a lucky one and sail through without terrible side effects. this decision is being prompted by my understanding that chronic inflammation is a terrible enemy in this fight. do you think I am balancing my considerations intelligently? And, 2) when I do my airway clearance, at the end of the saline dose, I’ll extend my expelling time with autogenic drainage and push this whole process close to an hour. This easily produces a half a cup! Then, I just get bored, distracted, fed up and walk away. I’m good for the day, as far as not needing to cough, which has been a godsend. But I am constantly producing all day long, and either subtly or not so subtly expelling it. I’m starting to think I should have a marathon session and just keep going with the autogenic drainage… Is that crazy? To sit for hours and just expel expel expel? Thanks as always for your collective insight!
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I have a question for Sue about your previous post. You said not to clear secretions by coughing through your vocal cords or clearing your throat. Can you explain that more? I’m doing both of those all day long as well as when I’m deliberately doing airway clearance. Am I damaging my throat and vocal cords?
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1 ReactionI would say you may be irritating your throat and vocal chords, probably not actually damaging. But then the irritation causes more of a sensation, and you clear again... My original pulmonologist's nurse - back when each doc had one who worked for them for years and got a lot of experience taught me the following tricks. (At the time I had bronchitis, pseudomonas, MAC, and it felt like I was coughing half the day, and clearing my throat the other half.)
Keep water with me all the time. When the urge to cough hit, swallow, take a sip of water, and see if it went away. If not, take 3-4 breaths, then huff cough 3-4 times. At first I was lucky if I could take ONE breath before trying a huff cough. Eventually (measured in months) I was able to manage, and my throat was a lot less sore.
Clearing my throat was a years long habit, and harder to break. At first I did the sip, breathe, cough as above. Even after my cough eased (over a year) I still found I habitually cleared my throat. Since I was no longer leashed to my water bottle, I needed a new strategy. So over time I learned to do this - when I get that feeling that I need to clear my throat, I swallow. If the sensation doesn't go away, I stop, take a breath or two and huff cough once or twice. It usually does the trick. I still find I clear my throat when under stress.
Sue
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3 ReactionsThank you Sue. I’m not familiar with huff coughing but will look it up. I live in a rural area with no pulmonologists and one ID doctor for 3 or 4 counties. I’m so thankful for this site so I can learn what I should be doing.
Hi Irene……do you do postural drainage every day also? If so, did you have lessons from a respiratory therapist?
Bon
Hi Bon, I use the Aerobika after nebulizing saline. I first use it sitting, then laying on my back hips slightly elevated, head slightly lower, then on each side. I guess that is postural drainage but I never had lessons from anyone. Just discovered out of necessity what worked.
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2 ReactionsThanks Irene. Does the postural bring up a lot?
the largest amount of sputum comes up when I do the laying on my back using the Aerobika. However that does not mean you will have the same experience. I have chronic mucoid Pseudo which can produce a lot of mucus and I have had Bronchiectasis for a long time. Why the large amount will not come up unless I lay on my back using the Aerobika (and then sit up to cough it up multiple times) I do not know. And my Pulmo has no explantion about the reason either. It is hard to compare our vastly different bodies. But on the other hand someone posted this suggested technique from her pulmo and it has helped more than I can say. We have to find a good balance of sharing and realizing how different we can be. Try it and see if it helps.
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4 ReactionsIt was my ID doctor (Winthrop at OHSU) who suggested this, but I don't have as much success with it as Irene does. I get the most sputum while and just after nebulizing, then more with the Aerobika while sitting, sometimes a tiny bit more on my back, rarely anything on my sides. As you say, each of us is different. I do the nebulizing and upright Areobika daily, usually twice a day, and still try to do the whole "set" a few times a week as I want to give my body the best chance to control these bugs.
Anna
Yes many thanks Anna. I guess it depends on where the mucus lodges? My need to use the laying on back position along with Aerobika started about 1.5 years ago. Prior to that I could get it all up while sitting.
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1 ReactionIt's helpful to read that no only do others cough up stuff all day, but they also get sick and tired of it!
What I would really like is to believe is that I will ever get to a point where I am not coughing constantly AND spitting into a cup. NO amount of airway clearing "finishes", and so I do wind up walking away..but then I just keep spontaneously producing. I am exhausted. My Pulom is trying me on Azithro, no change after one month, so perhaps she'll up the dose to 500mg 3x a week.
My sputum tests were negative, so I guess that means I do NOT have MAC??
What next I wonder???